[Objective] To gain more insight into the presentation,diagnosis of Bertolotti's syndrome and to investigate the indications,the procedure and the early clinical results of minimally invasive transverse process plasty.[Methods]Thirteen cases(Santavirta Type I)with Bertolotti's syndrome underwent minimally invasive transverse process plasty under MED X-tube(Medtronic Sofamor)from Apr.2006 to Dec.2008.The Visual Analogue Scale(VAS),Modified Oswestry Disability Index(ODI)score and subjective sensation of patients were recorded to evaluate the function.[Results]The operation blood loss was from 120 ml to 800 ml and operative time was from 60 to 280 minutes,average 115minutes.There was no severe complication.Nine cases were followed up for 10 to18 months,average 13.6 months.The VAS decreased from(6.7?2.2)before operation to(2.2?0.7)one week after operation and(2.8?0.9)three months after operation.ODI score decreased from(27.8?3.6)before operation to(5.9?2.2)three months after operation.The results were excellent in 10 case and good in 3 cases.[Conclusion]Minimally invasive transverse process plasty is an effective method for Bertolotti's syndrome,especially for Santavirta type I.It shows less blood loss and injury and deserves to be spreaded.Disectomy is recommended in one stage if the patient is complicated with disc herniation.

Objective To detect micronuclei (MN) induced by nickel chloride (NiCl2) using a flow cytometry-based method, so as to study the mutagenecity of this chemical. Methods The micronucleated reticulocytes (MN-RET) in peripheral blood of NIH mice exposed to 0.75 mg/kg colchicines (COL), 40.0 mg/kg of cyclophosphamide (CP) and 5.0, 10.0 and 20.0 mg/kg of NiCl2 were detected by a flow cytometry-based method, in which anti-CD71-FITC and PI were used to stain cells and malaria-infected erythrocytes were employed as biological standards of micronuclei to optimize cytometry. Results Although COL or CP induced significant increase in the frequency of MN-RET in peripheral blood, MN formation in peripheral reticulocytes was not significantly affected by exposing to different concentration of NiCl2. Conclusion The results of flow cytometric analysis in the present paper do not support that NiCl2 exposure may induce significant MN-RET increase in peripheral blood in NIH mice.

Objective To understand the true feelings of the patients with cervical intraepithelial neoplasia, and explore effect in patients with cervical intraepithelial neoplasia negative psychological experience. Methods Adopted purposive sampling,13 patients were in-depth interviewed,and the method of phenomenological analysis data were used. Results Analyzed of the psychological experience of patients with cervical intraepithelial neoplasia,extracted five topics: psychological overload,life was affected, the sick didn't adapt to the reality,self-assessment was low, the lack of information of disease. Conclusions The patients with cervical intraepithelial neoplasia have more negative psychological experience, and are in lack of information associated with disease and not satisfied. Nursing staff should take effective measures according to the actual situation of patients to promote their physical and mental rehabilitation.

Objective To observe the influence of large dose of mecobalamin combining with breviscapin injection on the levels of serum tumor necrosis factor-α(TNF-α)and C-reactive protein (CRP)and the antithrombin Ⅲ(AT-Ⅲ)activity in the patients with diabetic foot(DF).Methods 240 cases of DF were divided into 4 groups according to the random number table method,60 cases in each group:the large dose of mecobalamin plus breviscapin injection group (group Ⅳ);the routine dose of mecobalamin plus brevis-capin injection group (group Ⅲ);the simple breviscapin injection group (group Ⅱ)and the routine dose of mecobalamin group (groupⅠ).4 weeks were taken as a course of treatment.The TNF-α,CRP levels and the AT-Ⅲ activity before and after the treat-ment were detected and performed the comparative analysis.Results The levels of TNF-α,CRP and AT-Ⅲ before treatment had no statistically significant differences among in the four groups (P >0.05).Compared with the results before treatment,the levels of TNF-αand CRP after treatment in 4 groups were obviously decreased and the AT-Ⅲ level was significantly increased,the differ-ences had statistical significance (P <0.05);compared with the group Ⅰ,Ⅱ and Ⅲ,the difference in the group Ⅳ had statistical significance(P <0.05).Conclusion Mecobalamin combined with breviscapin injection is able to decrease the serum inflammatory factors such as TNF-αand CRP,and increase the AT-Ⅲ activity in the patients with DF,which is more significant when increasing the mecobalamin concentration.Therefore,adopting the therapeutical scheme of increasing the mecobalamin concentration combined with breviscapin injection could obviously decrease the inflammatory reaction of DF with good safety,which is one of effective meas-ures for increasing the curative effect of DF.

ObjectiveTo design a new operation approach:extreme lateral transforaminal lumbar interbody fusion (E-TLIF) via digital technology and to discuss its feasibility in treatment of degenerative lumbar diseases.MethodsCT scan image data of lumbar vertebra were obtained from volunteer (a healthy male of 26 years old,67 kg in weight and 172 cm in height).Mimics was used to read and reconstruct the data into 3D images.We observe the anatomical bone structures of intervertebral foramen and nerve roots through CT scan and 3D reconstruction in Mimics to analysis the feature of this area.Then E-TLIF operation,pedicle screw insertion and cage placement were simulated by computer via digital technology in Mimics.The feasibility of this new approach was proved through operating on lumbar of formalin doused body with E-TLIF approach.ResultsAn incision of 9 cm lateral form the central line and 45° from the sagittal plane is operated to fully expose the foraminal area.Remove superior facet while save inferior facet is feasible with this approach in E-TLIF.There is enough room for fully revealing and excision of intervertebral disc,and cage placement through enlarged foraminal area.Digital technology is a more economic,efficient way to design a new operation approach.The results are in accord with the formalin doused body test.ConclusionMimics is an effectively,reliable and economic method to design an operation approach.And the result suggested that E-TLIF is a safe,less minimal invasive and more efficient operation approach in treatment of degenerative lumbar diseases.

Objective To study the clinical treatment methods for properties of unknown in elderly patients with atypical squamous cell of undertermind significant and above cervical lesions.Methods According to the clinical grouping of ASCUS in elderly patients with cervical lesions of different treatment methods,observation group 1 (348 cases) underwent colposcopy;observation group 2(316 cases) for high-risk human papillomavirus(HPV) detection,HPV positive colposcopy ;observation group 3 (129 cases) of cervical cytology examination regularly,squamous intraepithelial lesion colposcopy,compared three groups of clinical treatment.Results Liquid based cytology and three groups of 574 patients (TCT) and colposcopy and cervical biopsy,the results of intraepithelial neoplasia(C IN) above cervical lesions in 223 cases(38.9%),in which CIN Ⅰ 136 cases(23.7%),CIN Ⅱ in 64 cases(11.2%),CIN Ⅲ 20 cases(3.5%),3 cases of carcinoma in situ(0.5%) ;the group1 were observed in 348 cases,348 cases underwent colposcopy biopsy(100%),CIN Ⅱ above 36 cases(10.3%) were observed in the group 2;213 cases of colposcopy biopsy(67.4%),CIN Ⅱ above 38 cases (12%) were observed in the group 3 ; colposcopy examination in 13 cases (10.1%),3 cases of biopsy CIN Ⅱ of the cases(2.3%).Biopsy of CIN Ⅱ above the detection rate,the observation group 1,observation of the 2 groups had no significant differences(P ＞ 0.05),and observe the difference between the 3 groups was statistically significant(x2 =7.014,9.156,all P ＜ 0.05).Conclusion High-risk HPV detection of shunt ASCUS can reduce cervical lesions treatment process misdiagnosis,missed diagnosis and treatment of the problem of excessive.

BACKGROUND:Tantalum rod implant technology is a new method of early osteonecrosis treatment. Current research on stress distribution before and after tantalum rod implant in different sizes of femoral head necrosis area is few. OBJECTIVE:To analyze the stress distribution before and after tantalum rod implantation in different sizes of necrotic femoral head area using three-dimensional finite element method. METHODS:Three-dimensional finite element models of normal femoral head and necrotic femoral head of 15, 20 and 30 mm diameterwere constructed. Eight measuring points were chosen on two tiers of each necrotic model to detect the stress distribution and its alteration before and after tantalum rod implantation. RESULTS AND CONCLUSION:(1) Stress concentration werefound on every necrotic femoral head, most pronounced on the one with 30 mm lesion. (2) Tantalum implant appeared to reduce the stress concentration generaly. Comparison of the peak points of these models indicated most significant benefit in 15 mm lesion, next in 30 mm lesion, last in 20 mm lesion. (3) Results indicate that larger lesion entails more concentrated stress distribution and more likely to colapse. Tantalum rod implantation can delay the development of necrosis of the femoral head, andismost effective in smal lesion.

Objective To investigate the effect of laparoscopic lymphadenectomy in patients with adenocarcinoma of esophagastric junction (AEG).Methods 105 patients with AEG underwent open or laparoscopic surgery from June 2014 to September 2015 were enrolled in the study and divided into minimally invasive group (n = 70) and laparotomy group (n = 35). The baseline data, lymphadenectomy result and perioperative data were compared between the two groups.Results Total number of splenic hilar lymph nodes dissection in minimally invasive group was significantly more than that in laparotomy group (P < 0.05). But there were no significant differences in the total number of lymph node dissection, number of positive lymph node dissection, positive rate of all node, number of positive splenic hilar lymph node dissection and positive ratef of splenic hilar lymph node between two groups (P > 0.05). Operation time, intraoperative blood loss, length of incision, positive proximal margins rate, thoracoabdominal resection rate and spleen resection rate in minimally invasive group were significantly lower than that in laparotomy group, esophagus resection length was significantly bigger than that in laparotomy group (P < 0.05). No death occurred postoperatively in all patients. The time of anus exsufflation, first intake liquid diet and postoperative ambulatory episode in minimally invasive group were significantly lower than that in laparotomy group (P < 0.05). There were no significant differences in the incidence of complications between two groups (P > 0.05).Conclusions Compared with open surgery, laparoscopic surgery is superior in splenic hilar lymph nodes dissection of AEG, with longer esophageal cutting distances, lower thoracoabdominal resection and spleen resection rate. It is safe and feasible, worthy of clinical promotion.

Diagnosis, Differential ; Echocardiography, Doppler, Color ; Heart Defects, Congenital ; diagnosis ; physiopathology ; Humans ; Infant, Newborn ; Male ; Pneumonia ; diagnosis ; physiopathology ; Pulmonary Artery ; abnormalities ; diagnostic imaging ; physiopathology ; Tomography, X-Ray Computed ; Trachea ; abnormalities ; diagnostic imaging ; Vascular Malformations ; diagnosis ; physiopathology

Objective To evaluate the correlations of vascular structures,hemodynamic changes and recanalization before receiving carotid endarterectomy ( CEA) in patients with subtotal or complete occlusion of carotid artery using color Doppler flow imaging (CDFI) and transcranial Doppler (TCD) ultrasonography. Methods A total of 107 patients were diagnosed as subtotal ( stenosis rate 95% to 99%) or complete occlusion of carotid artery with DSA and treated with CEA at Beijing Xuanwu Hospital, Capital Medical University from January 2005 to January 2014 were enrolled retrospectively. The mean age of patients was 61 ± 9 years. According to the findings of DSA,they were divided into either a carotid artery subtotal occlusion group (n=63) or a complete occlusion group (n=44). The vascular diameter,the locations of the lesions ( internal carotid artery or common carotid artery) ,the lumen echo characteristics,and whether internal-external artery collateral circulation patent or not at different stages in patients of both groups were documented. Results The lumen diameter of distal segment was significant wider in patients of the complete occlusion group compared with the subtotal occlusion group (4. 1 ± 1. 1 mm vs. 3. 2 ± 0. 8 mm). There was significant difference between the 2 groups (P <0. 01). There was no significant difference between the location of occlusion and the recanalization rate (P=0. 460). The recanalization rate of the lumen homogeneous echo ( hypoecho and echodense) filling patients (94. 1% vs. 86. 7%) was significantly higher than that of the patients of heterogeneity echo. In patients with complete occlusion of internal carotid artery,the recanalization of CEA would increase when the internal-external collateral arteries were patent. For general comparison,the recanalization rate of the subtotal occlusion group was significantly higher than that of the complete occlusion group (P<0. 01). Conclusion The carotid artery diameter normal or broadening ,the homogeneous echo in the occlusive lumen and the internal-external collateral arteries patency are closely associated with the recanalization rate. The preoperative ultrasonography has great value for the assessment of recanalization of carotid artery occlusive disease after CEA.